Case Studies

Conquer Cholesterol: The Bad with the Good


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Monty — a memorable name for a memorable person. Monty was a big guy, and when it came to cholesterol, he had big numbers. His total cholesterol was more than 325, and the other numbers — LDL cholesterol (so-called “bad” cholesterol) and triglycerides followed suit.

These days, thanks to the media, most people understand the significance of these numbers, at least somewhat. And although medical science can’t tell you exactly what the numbers mean, it has become clear that high values for total cholesterol, LDL cholesterol and triglycerides are not good for your health. Along with blood pressure, these numbers are early indicators of a patient’s risk of developing chronic heart disease, and of experiencing, or even dying from, a heart attack or stroke.

What the media often does not mention is that the high cholesterol and hypertension that often lead to coronary artery disease (CAD) also can play a major role in producing many symptoms associated with aging (at least in many developed countries) — especially sexual dysfunction in men and women, poor memory (and eventually Alzheimer’s), inability to walk very far without pain, and nerve pain (neuropathy).

Cleaning Up Monty’s Act

Monty and I talked for nearly an hour at our first meeting. He had a lot of questions — he had just been told by his doctor to “clean up his act” or suffer the consequences. Other tests from his doctor showed that some of his coronary arteries were already partially blocked. Monty did not know much about a healthy lifestyle. He loved fast foods, but told me, “My wife and doc are both pushing me to change my diet, or else. The thing is,” he continued, “my wife also has high cholesterol and high blood pressure. She’s about 50 pounds overweight. I want to bring her in next time. We have a plan to clean up together.” Before menopause, women have only about 40 percent the incidence of heart attack as men, but after menopause, and the decline of estrogen, the comparative risk rises to 70 percent or higher.

I gave Monty a handout that rates common foods and drinks for their potential to promote heart disease and, eventually, serious cardiovascular symptoms. Major benefits come from eating as high on the “heart-friendly scale” as possible every day. A problem with heart disease is the slow and persistent damage to all of our body’s vital vessels that happens silently — we often aren’t aware of the damage until a major symptom or sign occurs. No matter what kind of symptom patients come in for, I always ask them about their heart-healthy plan. It’s my job as a health-care provider to encourage all my patients to have a 10- and 20-year plan for their heart. Studies have shown that even some teenagers already have significant damage in their cardiovascular system.

Best and Worst Foods for Heart Health

This scale shows the best and worst choices of foods for heart health. In this chart, a rating of 10 is the most beneficial; 1 is the least. In general, when it comes to heart-friendly foods, think fiber!

Change Lifestyles Together

Two weeks after I saw Monty for the first time, he and his wife, Liz, came in together. Liz looked strong, but heavy for her frame. She was about 55, and very sharp. She wondered if herbal medicine could help reduce her cholesterol and blood pressure and decrease her weight.

For many people, especially “mesomorphs,” or stocky, muscular types, stress hits the liver first, which can influence the way the various types of cholesterol are managed in the body. It’s the liver that manufactures the cholesterol in the first place, and the liver that breaks it down. Most important, the HDL (high-density lipoprotein, or “good” cholesterol) molecules the liver manufactures help shuttle cholesterol out of cells, preventing a buildup that could promote CAD. More than any other kind of cholesterol, it is important to have a sufficient amount of HDL in the blood to protect our heart and vessels. Studies show that people with a genetic profile that dictates lower production of HDL are at a much higher risk of developing CAD and dying of it.

Both Monty and Liz had risky numbers when it comes to the common test that most people get — the HDL to total cholesterol ratio. A better test, with a more accurate predictive value, is the LDL to HDL ratio. The test costs a bit more, but is worth it.

Herbal Cholesterol Regime

Monty and Liz both were willing to stick to an herbal regime, and they were serious about limiting some of the lowest-scoring foods on the heart-friendly scale, especially foods and drinks with refined sugar. Some recent studies show that sugar might be more risky than saturated fat in the process of inflammation and destruction of the vessel linings that lead to CAD.

Because Monty and Liz had signs of chronic inflammation, liver stagnation and cholesterol imbalance, I designed three herbal formulas, as follows. The herbs are useful for many people who have cholesterol imbalances, and are widely available in capsule and tablet form, and as bulk herbs to make teas. I recommend visiting a health-care provider before getting started on a cholesterol-lowering herbal regime. Herbal formulas work much better when they are matched to each individual. It is vital to make sure your doctor knows about your herbal program if you are on any pharmaceutical medications, such as statin drugs.

The first formula was created to balance the liver and reduce liver inflammation. Herbs to balance the liver (which can help keep cholesterol in a healthy state) include boldo (Peumus boldus), dandelion root (Taraxacum officinale), burdock root (Arctium lappa) and yellow dock (Rumex crispus). These herbs are widely available in tincture form.

To drain pathogenic heat and dampness from the lower part of the body, I combined two Chinese herbs, phellodendron (Phellodendron chinense) and sophora root (Sophora spp.), with the bitter herb gentian (Gentiana lutea). These are very effective herbs — the use of phellodendron or sophora root should be under the guidance of an experienced herbalist. Gentian is usually safe in any case.

Lastly, I wanted to regulate bile and reduce total cholesterol, while preserving or increasing HDL. A number of herbs are known to help reduce cholesterol while maintaining HDL. Scientific studies show that the following products can help reduce mildly elevated cholesterol, and they also work well with a total program for cholesterol and cardiovascular health.

Red rice yeast is a traditional fermented food that contains a substance that is chemically similar to lovastatin, a commonly prescribed cholesterol-lowering drug. A number of controlled human studies show that regular use can lead to total cholesterol reductions of up to 23 percent, LDL by 30 percent and triglycerides by 34 percent, while increasing HDL by up to 20 percent. The supplement is available online and in some health-food stores, even though the Food and Drug Administration has voiced disapproval because of its similarity to prescription statins. Some research suggests that red rice yeast may be effective with fewer side effects than comparable drugs, but consult your health-care provider before using it.

Some studies show that garlic (Allium sativum) has a modest cholesterol-lowering benefit, while others show no benefit. My research and experience shows me that the regular use of garlic in cooking, and/or the regular use of a high allicin-containing garlic capsule, can provide a definite benefit to the heart and cardiovascular system.

A standardized artichoke leaf (Cynara scolymus) extract can moderately reduce total cholesterol while preserving HDL levels. I often recommend up to a double dose for best results.

Shiitake (Lentinula edodes) or reishi (Ganoderma lucidum) mushrooms may be used in cooking (or in supplements) on a regular basis to help lower cholesterol levels.

Persistence Yields Good Results

I was very confident that Monty and Liz would both see fairly rapid changes, and at least Liz did. She ended up losing 25 pounds, which is where she stabilized for about a year. Her LDL to HDL cholesterol panel returned to the safe range, and stayed there.

Monty was a harder case. He lost some of his excess weight with dietary changes and some extra exercise. His cholesterol numbers did improve, but not enough. His total cholesterol fell to about 250. After three months, he started the red rice yeast, and this further reduced his cholesterol to about 200. His LDL to HDL ratio finally reached 5 (in the “average risk” range), and his doctor, who at first was very skeptical, began to accept the results as satisfactory.

Christopher Hobbs’ case studies are gleaned from his 30 years of studying and practicing herbalism. Hobbs, a fourth-generation botanist and herbalist, is the creator of the correspondence course Foundations of Herbalism;

“Case Studies” is not intended to replace the advice of your health-care provider.